# KELLEY FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457523805
- **Authorized official:** DR. DARRON HARRIS KELLEY DDS (CEO)
- **Authorized official phone:** (208) 852-2564

## Contact information

- **Practice address:** 35 S STATE ST, PRESTON, ID 83263-1239
- **Practice address phone:** (208) 852-2564
- **Mailing address:** 35 S STATE ST, PRESTON, ID 83263-1239
- **Mailing address phone:** (208) 852-2564

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D-3719 | ID | Yes |

## Other

- **Enumeration date:** 03/26/2008
- **Last updated:** 03/26/2008